But this is different.

If someone’s in danger, duty to warn supersedes your duty to maintain confidentiality. You must act if your patient (or others) may come to harm.

How Do I Act?

It depends what constitutes the potential harm. The following are three examples:

A patient who is talking about killing themselves.

A teenage patient with cuts on their forearms.

A patient who is obviously under the influence of drugs or alcohol.

What should I do?

If you believe there is an immediate risk of harm, for example:

The patient’s suicidal ideation is at a critical point—call a family member.

The teenager’s cuts are fresh—contact a parent.

The patient who is under the influence of alcohol or drugs is about to drive away—call the police.

If danger isn’t imminent, and you needn’t immediately act, you must obtain patient consent to proceed. If the patient is considering but not yet attempting suicide, you might call their family doctor or a counselor. Ask the teen if they’ve told anyone about their cutting behavior. See if the alcoholic or addict has any kind of support in place. If not, can you call someone for your patient? How can you best assist them?

Unfortunately, if the patient doesn’t want you to do anything, your hands are tied. But you should continue to monitor the situation, and if it worsens, consider acting.

Every situation is different. If you have any doubts about what to do, contact the Practice Advisor
practiceadvice@collegept.org | 647-484-8800 | 1-800-583-5885